The Clinical Core will recruit, evaluate and follow control subjects and selected patients; database pertinent information; assign patients to follow up and study protocols and employ a computerized system to monitor and document. Staff will assign patients to follow up and study protocols and employ a computerized system to monitor and document. Staff will attempt to reach a 80% follow up rate for persons designated for long- term study, will maintain minority recruitment at 30% (continuing to emphasize Native Americans) and will work toward an epidemiologic study of dementia in Native Americans at the Urban Inter-Tribal Center of Texas. Well-studied subjects, clinical data and body fluids will be supplied to ADC investigators. Neuropsychological data will be examined to determine the possible presence of profiles that can detect persons with minimal cognitive impairment who will develop AD. Neuropsychological data will be gathered for studies of normal aging (e.g., Drs. Chapman and Cullum's R01 submission "Spared and Impaired Cognitive Abilities in Advanced Aging") and for correlation of clinical data with neuropsychological, imaging, CSF, and neuropathological findings. The sensitivity and specificity of neuropsychological tests and patterns in aging and dementia will be determined, and collaboration with the ADCS will be continued with especially close collaboration on studies on studies involving the management of emotional and behavioral symptoms in AD patients. Clinical core staff will further characterize and implement the use of its two new assessment tools, the Texas Functional Living Scale (an IADL scale) and the Quality of Life in Dementia Scale for ascertaining quality of life in late-stage dementia patients. The ADC series of neuropathologically validated cases examined by singled-proton computerized tomography (SPECT) will be extended and the use of SPECT will be continued to clarify diagnosis in challenging cases. Neuroimaging modalities such as functional MRI will be used to initiate studies of dementias and to extend imaging studies to related diseases. In the area of training, the ADC is sponsoring a post-residency research fellowship for a psychiatrist and a one-year post-residency experience in diseases of higher cortical function for a neurologist; both of these physicians will be recruited to the group of ADC investigators. We have received a grant from Pfizer-Eisei with UT Dallas on the effect of cognitive discourse interventions in AD patients receiving cholinesterase inhibitor and we will continue an inter-university R01 to study the impact of caregiver mental health on caregiving.